The
Supreme
Court
has
issued
its
long-anticipated
ruling
in
Braidwood
Management
v.
Becerra,
affirming
the
constitutionality
of
the
Affordable
Care
Act
provision
that
requires
insurers
to
cover
certain
preventive
services
recommended
by
the
U.S.
Preventive
Services
Task
Force
without
cost-sharing.
This
includes
cancer
screenings,
pregnancy
care
and
testing
for
sexually
transmitted
diseases.
Several
Texas
residents
and
two
Christian-affiliated
businesses
had
sued
the
government,
arguing
that
the
provision
violates
the
appointments
clause,
which
requires
that
officers
of
the
U.S.
only
be
appointed
by
the
president
with
advice
and
consent
of
the
Senate.
Members
of
USPSTF
were
not
nominated
by
the
president
and
approved
by
the
Senate.
They
also
argued
that
covering
benefits
like
preexposure
prophylaxis
(PrEP),
which
is
used
to
prevent
HIV,
goes
against
their
religious
beliefs,
violating
the
Religious
Freedom
Restoration
Act
(RFRA).
In
a
6-3
ruling
authored
by
Justice
Brett
Kavanaugh,
the
Supreme
Court
stated
that
the
U.S.
Preventive
Services
Task
Force
are
inferior
officers
and
don’t
require
Senate
approval,
and
therefore,
their
appointment
was
constitutional
under
the
appointments
clause.
HHS
Secretary
Robert
F.
Kennedy
Jr.
has
the
power
to
appoint
and
fire
members
of
the
task
force,
and
review
and
block
their
recommendations.
Justices
Clarence
Thomas,
Samuel
Alito
and
Neil
Gorsuch
dissented.
In
regards
to
the
religious
claim,
the
district
court
ruled
in
favor
of
Braidwood.
The
Supreme
Court
noted
that
the
government
did
not
appeal
this
part
of
the
district
court’s
judgment,
so
the
religious
issue
remains
with
the
district
court,
said
Daniel
Frier,
a
healthcare
attorney
and
founding
partner
of
Frier
Levitt.
“The
Court’s
handling
of
the
religious
freedom
claim
signals
that
employers
with
sincerely
held
religious
objections
may
still
seek
exemptions
from
certain
coverage
mandates
under
RFRA.
The
ongoing
proceedings
in
the
district
court
on
this
issue
could
influence
the
scope
of
religious
accommodations
available
under
federal
health
care
law,”
he
added.
Had
the
Supreme
Court
decided
differently
on
the
appointments
clause,
the
government’s
ability
to
require
insurers
and
employers
to
cover
preventive
services
without
cost
sharing
could
have
been
severely
limited.
An
executive
from
the
American
Cancer
Society
Cancer
Action
Network
applauded
the
decision.
“In
a
critical
ruling
that
helps
reduce
the
cancer
burden
nationwide
by
ensuring
affordable
access
to
evidence-based
cancer
screening
and
preventive
services,
we
are
pleased
that
today
the
Supreme
Court
upheld
the
provision
of
the
Affordable
Care
Act
that
requires
most
private
insurers
to
cover
many
lifesaving
preventive
care
services
without
cost
sharing.
Research
has
shown
that
any
out-of-pocket
costs
can
be
a
deterrent
to
accessing
proven
cancer
screening,
which
can
be
the
difference
between
life
and
death,”
said
Lisa
Lacasse,
president
of
the
American
Cancer
Society
Cancer
Action
Network,
in
a
statement.
Families
USA,
an
advocacy
group
for
healthcare
consumers,
said
the
decision
provides
some
security
to
more
than
170
million
Americans
by
preserving
their
access
to
preventive
services
without
cost-sharing.
Still,
there’s
cause
for
concern,
said
Anthony
Wright,
executive
director
of
Families
USA.
“While
this
is
a
foundational
victory
for
patients,
patients
have
reason
to
be
concerned
that
the
decision
reaffirms
the
ability
of
the
HHS
secretary,
including
our
current
one,
to
control
the
membership
and
recommendations
of
the
US
Preventive
Services
Task
Force
that
determines
which
preventive
services
are
covered,”
Wright
said
in
a
statement.
“We
must
be
vigilant
to
ensure
Secretary
Kennedy
does
not
undo
coverage
of
preventive
services
by
taking
actions
such
as
his
recent
firing
of
qualified
health
experts
from
the
CDC’s
independent
vaccine
advisory
committee
and
replacing
them
with
his
personal
allies.”
Another
healthcare
expert
noted
that
the
“implications
of
this
case
cannot
be
overstated.”
However,
this
doesn’t
mark
the
final
chapter.
“The
decision
does
not
resolve
the
deeper
legal
and
political
uncertainty
surrounding
health
care
access,”
said
Greg
Fosheim,
a
partner
at
McDermott
Will
&
Emery.
“Braidwood
must
be
read
in
tandem
with
the
Court’s
recent
decision
in
United
States
v.
Skrmetti,
which
limited
federal
protections
for
access
to
gender-affirming
care.
Taken
together,
these
rulings
underscore
how
vulnerable
many
forms
of
essential,
compassionate,
and
evidence-based
health
care
remain
—
particularly
when
they
intersect
with
contested
social
or
religious
issues.”
Fosheim
emphasized
that
in
Braidwood,
the
Court
left
open
the
possibility
of
future
exemptions
based
on
religious
freedoms
for
services
like
PrEP.
This
suggests
that
“even
when
structural
elements
of
the
ACA
are
upheld,
access
to
comprehensive
care
can
still
be
narrowed
in
practice,”
he
said.
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